• H Domanovits, M Schillinger, M Müllner, J Thoennissen, F Sterz, A Zeiner, and W Druml.
• Department of Emergency Medicine, Vienna General Hospital, University of Vienna, Medical School, Austria. Hans.Domanovits@akh-wien.ac.at
• Intensive Care Med. 2001 Jul 1;27(7):1194-9.

ObjectiveTo assess the frequency and independent predictors of severe acute renal failure in patients resuscitated from out-of-hospital ventricular fibrillation cardiac arrest.DesignA cohort study with a minimum follow-up of 6 months.SettingEmergency department of a tertiary care 2200-bed university hospital.Patients And ParticipantsConsecutive adult (> 18 years) patients admitted from 1 July 1991 to 31 October 1997 after witnessed ventricular fibrillation out-of-hospital cardiac arrest and successful resuscitation.Measurements And ResultsAcute renal failure was defined as a 25% decrease of creatinine clearance within 24 h after admission. Out of 187 eligible patients (median age 57 years, 146 male), acute renal failure occurred in 22 patients (12%); in 4 patients (18%) renal replacement therapy was performed. Congestive heart failure (OR 6.0, 95% CI 1.6-21.7; p = 0.007), history of hypertension (OR 4.4, 95% CI 1.3-14.7; p = 0.02) and total dose of epinephrine administered (OR 1.1, 95% CI 1.0-1.2; p = 0.009) were independent predictors of acute renal failure. Duration of cardiac arrest, pre-existing impaired renal function and blood pressure at admission were not independently associated with renal outcome.ConclusionsSevere progressive acute renal failure after cardiopulmonary resuscitation (CPR) is rare. Pre-existing haemodynamics seem to be more important for the occurrence of acute renal failure than actual hypoperfusion during resuscitation.

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